Estimation of salivary tumor necrosis factor-alpha in chronic and aggressive periodontitis patients

Oral health status of Egyptian children with lysosomal storage diseases: An evaluation of dental indices, salivary cytokines level, and bacterial bioburden

BACKGROUND

Lysosomal storage diseases (LSDs), a group of inborn errors of metabolism, include various subtypes, for example, mucopolysaccharidosis (MPS) and Gaucher disease (GD). Besides the physical/mental disabilities, they suffer from several oral deteriorations.

AIM

To evaluate the oral health status of Egyptian children with LSD.

DESIGN

Thirty LSD children and thirty non-LSD children were enrolled for this study according to the inclusion and exclusion criteria. Dental indices were used to assess caries prevalence and periodontal status. Saliva samples were collected from all enrolled children to estimate interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), and protein levels as well as Streptococcus mutans and Lactobacilli colony counts.

RESULTS

Children with MPS and GD showed non-significant differences in decayed, missing, or filled teeth (DMFT) scores (p = .115). Scores of dmft showed a significant increase in MPS, but not in GD children (p = .020, p = .127). Children with LSD showed significantly increased Modified Gingival Index (MGI), Plaque Index (PI), Oral Hygiene Index (OHI-s) scores (p < .001) and salivary IL-6 and TNF-α (p = .007, p = .001, p < .0001, p = .002, respectively) and salivary total proteins (p = .001) levels. Unexpectedly, non-significant differences were observed in salivary Streptococcus mutans or Lactobacilli counts in children with MPS and GD (p = .058, p = .420, p = .502, p = .053, respectively).

CONCLUSION

To our knowledge, this is the first article that evaluates Egyptian children with LSD. We demonstrated high caries prevalence in primary teeth, not permanent teeth, in children with MPS and poor gingival/hygiene status in children with MPS and GD, which triggered a state of inflammation. The daily supplement intake prevented oral bacterial growth. The most probable cause of oral alterations is decreased salivary flow rate, as deduced from a significantly increased salivary protein.

A liquid crystal-based biosensor for sensitive detection of tumor necrosis factor-alpha

Tumor necrosis factor-alpha (TNF-α) is a cytokine secreted by the macrophages and Th1 cells of the immune system in response to inflammation. Given its significance as a biomarker with elevated levels in physiological fluids in various conditions, there is an increasing demand for a simple and accurate TNF-α detection strategy. In this article, we present a liquid crystal (LC)-based biosensor developed for sensitive TNF-α detection. The biosensor operates as follows: TNF-α and detection antibodies (DAbs) form complexes during preincubation. These complexes then bind with the surface-immobilized capture antibodies (CAbs), facilitating the antigen-antibody reaction between the CAbs and the TNF-α/DAb complexes. This target recognition interaction alters the surface topography, disrupting the vertical orientation of LCs produced by dimethyloctadecyl[3-(trimethoxysilyl)-propyl]ammonium chloride. The orientational change in the LCs can be easily visualized with a polarized optical microscope, resulting in brighter images as TNF-α levels rise. Our results demonstrated a linear range of 5.00-500 pg/mL, with a limit of detection and limit of quantification being 1.08 and 3.56 pg/mL, respectively. Recovery experiments on diluted saliva samples produced reasonable results, with TNF-α recoveries ranging from 97.1% ± 2.58% to 107% ± 5.95%.

Advances in Electrochemical Biosensors Based on Nanomaterials for Protein Biomarker Detection in Saliva

The focus on precise medicine enhances the need for timely diagnosis and frequent monitoring of chronic diseases. Moreover, the recent pandemic of severe acute respiratory syndrome coronavirus 2 poses a great demand for rapid detection and surveillance of viral infections. The detection of protein biomarkers and antigens in the saliva allows rapid identification of diseases or disease changes in scenarios where and when the test response at the point of care is mandated. While traditional methods of protein testing fail to provide the desired fast results, electrochemical biosensors based on nanomaterials hold perfect characteristics for the detection of biomarkers in point-of-care settings. The recent advances in electrochemical sensors for salivary protein detection are critically reviewed in this work, with emphasis on the role of nanomaterials to boost the biosensor analytical performance and increase the reliability of the test in human saliva samples. Furthermore, this work identifies the critical factors for further modernization of the nanomaterial-based electrochemical sensors, envisaging the development and implementation of next-generation sample-in-answer-out systems.

Awareness on the management strategy of stitch abscess among dental students

Stitch abscesses are abscesses that develop following surgical procedures as a result of suture infections. Because of nonabsorbable sutures, the material reacts with connective tissue, generating adhesions around the stitch. The use of this type of material increases the risk of infection. The aim of this study was to establish awareness on the management strategy of suture stitch abscess among dental students. An online survey consisting of ten questions about suture stitch abscess along with sociodemographic factors was circulated among equal numbers of 2^nd years, 3^rd years, final years, and compulsory rotatory residential internship (CRRI). The data obtained from the questionnaire were transferred to Microsoft Excel and imported to SPSS software for statistical analysis. Interns are more aware about the complications and management strategy of suture stitch abscesses compared to others. Awareness on the management strategy of suture stitch abscess is important, and it helps to reduce the side effects to improve the outcomes. Educating the risk factors, signs and symptoms, and management strategy is the best way to help raise awareness.

Current status of usage of ivermectin in the management of COVID

The antibacterial, antiviral, and anticancer properties of ivermectin make it a wonder drug with a wide range of possible applications. It works against a variety of microorganisms, including viruses. Ivermectin has a wide range of antiviral effects, according to in vivo research in animal models. Because ivermectin is involved in a range of biological processes, it could be a promising therapeutic candidate for viruses such as COVID-19 and other positive-sense single-stranded RNA viruses. The study aims to analyze the awareness about the current status of usage of ivermectin in management of COVID among students studying in a private dental college. A study based on questionnaire was organized among students studying in a private dental college in Tamil Nadu. The subjects were asked a series of structural questions based on the usage of ivermectin in management of COVID. The questionnaire was prepared with 10 questions. 150 individuals completed the questionnaire; all of their answers were tallied in excel and imported into SPSS. For statistical analysis, the Chi-square test was performed. Excel was used to tabulate and enter the data, and the SPSS package software was used to analyze it. The study's threshold for statistical significance was set at P < 0.05. From this study, we found that the students had limited knowledge about the usage of ivermectin for management of COVID. More studies should be conducted to widen the knowledge among the students about the current affairs of the world.

Evaluation of accuracy and time taken to make an open tray implant impressions with two techniques

Implant dentistry's emergence and acceptance have provided physicians with a wide range of new options for fixed and removable rehabilitation. The eventual replacement of the lost tooth is the ultimate success, and this can be accomplished using recognized prosthodontic methods. The present study aims to evaluate the time and dimensional accuracy of implant definitive models with an open tray impression with two different techniques. Impression was made in two different techniques and the cast was poured and checked for the time taken and the accuracy of the impression. In IBM SPSS software version 23.0 all the results were statistically analyzed. An Independent t-test was performed for the parameters. No statistically significant difference was present (P > 0.05) when comparing the accuracy and time taken between the two groups. It is concluded that time taken and the misfit is less for modified open tray impression techniques when compared to the regular open tray impression.

Awareness of usage of Vicryl suture material in oral surgical procedures

Oral surgical procedures constitute a very important part in the broad scope of general dentistry. This necessitates a significant need for dental students to know about the suture materials. This study aims to assess the awareness of Vicryl suture material in dental surgical procedures. The descriptive survey was attended among 237 dental students. Results were analyzed using Microsoft Excel and using SPSS software version 23.0. The majority (96%) of the dental students were aware of Vicryl suture material. Approximately 75% and 66% knew that Vicryl suture was absorbable and braided, respectively. However, only 33% knew that Vicryl suture would get fall off in 2 weeks. According to the statistics, there is no significant difference between gender and awareness of Vicryl suture material (Chi-square; P = 0.14, not significant). Dental students have adequate knowledge about Vicryl suture material.

Awareness about Patterson syndrome among dental students

The aim is to create awareness about Patterson syndrome among dental students. Patterson-Stevenson-Fontaine syndrome is a very rare condition marked by irregular facial bone and tissue growth (mandibulofacial dysostosis) as well as limb abnormalities. A recessed jaw (retrognathism), cleft palate, and external ear defects are all possible symptoms of this disorder. A total of 112 undergraduate dental students participated in a longitudinal cross-sectional sample. To assess college students' awareness about Patterson syndrome, a self-administered, closed-ended questionnaire was developed and distributed. The only language allowed was English. The results were analyzed in SPSS software version 23. 10.71% of females and 14.29% of males were aware about Patterson syndrome. 32.14% of females and 38.39% of males were aware that Patterson syndrome was a rare adrenal disorder. We can conclude that very few of the population which was only 25% of the dental students were aware about Patterson syndrome and this survey helped in creating awareness about this syndrome.

Presence of impacted supernumerary teeth in the Indian population

A tooth that does not erupt into the dental arch during the anticipated developmental window is said to be impacted. A supernumerary tooth (ST) would be any dentition or odontogenic entity that grows from a tooth germ more often than is typical for a particular area of the dental arch (ST). The study's goal is to determine how commonly impacted supernumerary teeth are present within the Indian community. This research project at the institution which was retrospective was done on dental patients who went to the private dental hospital between March 2020 and March 2021. We looked over the medical records of 86,000 patients at the private dental institution and analyzed the data. In the study's 74,421 impaction cases, 139 instances of impacted extra teeth were found. For statistical analysis, collected data were analyzed, entered into an Excel document, and imported into SPSS version 21. In the study population, males between the ages of 21 and 35 years were more frequently observed to have supernumerary impacted teeth. Impacted teeth were more frequently observed in the posterior region rather than the anterior region. Within the constraints of the study, it was shown that males between the ages of 21 and 35 years and the posterior part of the mouth experienced impacted supernumerary teeth the most frequently.

Evaluation of tensile strength of surgical absorbable and nonabsorbable suture materials after immersion in different fruit juices: An in vitro study

Surgical sutures are the most well-known surgical biomaterial device for ligating blood vessels. The primary goal of wound closure is to align wound margins to provide a closed and stable environment. Sutures with lesser tensile strength are susceptible to break throughout the healing process due to edema. To evaluate the tensile strength of absorbable and nonabsorbable suture materials after immersion in fruit juices. In this in vitro study, eight samples of commercially available sutures such as black silk and vicryl were divided into two groups: sample -1 were immersed in grape juice and sample -2 were immersed in lemon juice for 1 week. Universal testing machine INSTRON E300 UTM was used to test the tensile strength of various suture materials. The data are statistically analyzed using an independent t-test. The P < 0.05 was considered to be statistically significant. The mean of vicryl suture after immersion in grape and lemon juice was found to be 34.445 and 43.39; the mean value of black silk after immersion in grape and lemon juice was found to be 36.95 and 33.1. The tensile strength of black silk was slightly lower than the vicryl. Independent sample t-test showed that P = 0.561 (>0.05) which is statistically insignificant. Vicryl suture tested to have the highest tensile strength along with excellent knot holding capacity than black silk suture after immersion in fruit juices.

Knowledge, awareness, and prevalence of various types of suturing techniques used for intraoral wound closure

Wound closing is critical to the completion of any surgical operation. An imperfect closure causes edge isolation, creating a possible route for bacterial contamination, which can lead to infection and scarring. While tissue adhesives and staples are now used as substitutes, surgical sutures remain the gold standard for a safe wound. The aim of this survey is to assess dental students' knowledge on the variety of suturing techniques. A comprehensive online survey of 100 dental students with simple questions about different types of sutures was performed. Each student was asked to complete a questionnaire of 20 questions. This study saw a total of 100 students take part in it. It was found that 58% of the participants opted for interrupted suturing technique and the rest 42% opted for simple continuous technique. It was found that 23% of the participants were not aware of the simple loop suturing technique and the rest 77% were aware of this suturing technique. Thus from the above results and discussion, we will conclude that almost all of the members are fairly privy to the distinctive suturing strategies; however; intensive expertise is required.

Awareness on resonance frequency analysis in dental implantology among dental practitioners and dental students

In a partial or entirely independent jaw, oral implantology is a technique in dentistry used to enhance the function of mastication, esthetics, and phonation. An important diagnostic aspect for the effectiveness of implant therapy is the stability of the implants. This study aims to measure dental professionals' and dental students' knowledge of resonance frequency analysis (RFA) in dental implantology. This study aims to measure dental professionals' and dental students' knowledge of RFA in dental implantology. One hundred ninety-nine dentists and dental students participated in an online survey study that was delivered through Google Forms. For statistical analysis, tabulated data from the Excel sheets were transferred into the SPSS program. The Chi-square test is also used to examine clinical relevance. According to the study's findings, 60% of the respondents were male and 46% of those who responded were dental professionals. The respondents were primarily between the ages of 18 and 22 (36%). The majority of dental undergraduates and graduates were found to be knowledgeable about the various techniques used to gauge implant stability (P = 0.04 < 0.05). Within the limitations of this study, it was found that most of the dental students and dental practitioners participating in this study were aware of implant stability. The majority of the respondents were aware that RFA was used to measure primary and secondary stability and osseointegration.

Awareness and knowledge of oral manifestations in cardiovascular diseases among the general public

Cardiovascular diseases (CVDs) are disorders affecting the heart and blood vessels. Periodontal problems, bleeding gums, dry mouth, and gingival hyperplasia are common oral manifestations seen in cardiovascular-related problems. To assess the extent of awareness and knowledge, the general public has toward the oral manifestation related to that of CVDs. A questionnaire was distributed among the general public in relation to that of the extent of awareness and knowledge of oral manifestations with regard to CVD. A total of 161 responses were collected from the survey. The collected data were compiled and analyzed by the SPSS software; the Pearson Chi-square test was done where P < 0.05 was considered statistically significant. The study showed that 65.22% of the population is aware of the types of CVD. About 59.63% of the population do not know that periodontal problems lead to cardiovascular problems. About 39.75% have vague knowledge about the maintenance of poor oral health causing cardiovascular problems. The study concluded that the general public is not much aware of the oral manifestations related to that of CVDs.

Average time in between appointments for multivisit pulpectomy in patients reported to a university dental hospital

Complete removal of the infected coronal and radicular pulp tissue along with obturation of the canal space with suitable medication is defined as pulpectomy. The most common indication for pulpectomy is a tooth with irreversible pulpitis which shows symptoms of nocturnal pain and abscess. To determine the average time in appointments for multivisit pulpectomy in patients reported to a university dental hospital. It is planned as a retrospective analysis of the case records of patients who were treated as two visit pulpectomy procedures in a university dental hospital, India. The study concluded that in the majority of the situations the average time in between appointments for multivisit pulpectomy was found to be within 1 week.

Evaluation of difficulty index of impacted mandibular third molar extractions

When compared to other teeth, third molars have a greater rate of impaction. Third molars that have been impacted are commonly encountered in dental practice, and it is the reason for complications in third molar surgery. The most commonly performed surgical procedure by dental practitioners is the third molar extraction. Despite a well-planned surgical approach, there are complications in lower third molar extractions. This study analyzes the expected difficulty during surgical removal of lower third molars that are impacted. This study analyzes the expected difficulty during the removal of impacted lower third molars by surgery. With the data from our dental institution database, the difficulty index by Pederson was used to evaluate the difficulty level of the extraction. Using SPSS, data were analyzed and results were obtained. Among impacted left mandibular third molars (38), minimal difficulty in 20.60% of the extractions, moderate difficulty in 29.58% of the extractions, and most difficulty in 2.77% of extractions were present. Among impacted right mandibular third molars (48), minimal difficulty in 18.80% of the extractions, moderate difficulty in 25.78% of the extractions, and most difficulty in 2.47% of extractions were present. According to our study, there is moderate difficulty in impacted lower third molar surgery, and it depends on factors such as systemic status and patient's age, periodontal condition, and complexity of tooth position in the dental arch.

Expectation of treatment outcomes in complete denture wearers

Edentulism is a condition associated with age, and the outcome of prosthodontic treatment depends on a number of dental and nondental factors. In complete denture therapy, patient satisfaction is a key objective and various other variables affect this parameter. The ability to foresee its preferences may assist dentists in making informed treatment selections. The study purpose is to assess the expectations of treatment outcomes in complete denture users. For the study, all cases referred for total denture therapy during September 2020 and February 2021 were included. Both new and old denture users completed questionnaires on factors such as retention, mastication, phonetics, esthetics, and comfort. Excel was used to compile the data, which was then imported into SPSS for statistical analysis. The study's statistical significance level was established at P < 0.05. Male patients over the age of 60 years wearing dentures were very common. Denture wearers were highly prevalent in the age group of >60 years among male patients. Retention, esthetics, and phonetics are highly satisfied in existing denture wearers and mastication is highly satisfied in new denture wearers. The comfort factor is commonly satisfied in both the denture wearers. The results were statistically significant with a P = 0.05. Clinician can plan their treatments more effectively if they are aware of the treatment's expectations.

Knowledge and awareness of the Klinefelter Syndrome among the dental students

The presence of one or more extra X chromosomes in a male causes Klinefelter Syndrome (KS). KS affects 1 in 500-1 in 1000 men, while about half remain undiagnosed. KS is characterized by huge stature, increase in arm length, the feminine distribution of adipose tissues (including gynecomastia), less or pubic hair, infertility, hypotonia, reduced size of penis and less than average verbal IQ, struggle in learning and requirements for less specified speech therapy. KS is a primary testicular insufficiency with high levels of gonadotropin caused by a lack of pituitary gland feedback. The aim of the study is to assess the knowledge and awareness of the KS among the dental students. This cross-sectional survey was conducted among dental students of a private dental hospital. To evaluate the knowledge and awareness of the participants about KS, a self-administered questionnaire consisting of 10 questions was prepared. Percentage analysis and frequency analysis and percentage analysis were performed. A Chi-square test was done to assess the correlation using the SPSS software. In our study, most of the participants were aware of the KS. They also knew that the KS is caused due to the additional X chromosome. We would like to conclude that the dental students were much aware about the Klinefelter and they also had a thorough knowledge about it.

Awareness on current status of usage of ritonavir in the management of covid among dental students

Ritonavir's pharmacodynamics raise questions regarding whether medication concentrations high enough to block the SARS-CoV-2 proteases can be obtained. Ritonavir may have a therapeutic benefit at any stage of the disease, although pharmacodynamic issues and the absence of clinical benefit data among hospitalized COVID-19 patients cast doubt on this claim. To study the awareness on current status of usage of ritonavir in the management of COVID among dental students. This study, which is survey-based, involved a sample of 100 individuals and was carried out on the website Survey Planet. The study included undergraduate and graduate dental students. The dental students were given a questionnaire containing 10 questions. Their responses were gathered. The number and percentage were used to summarize the data. Dental students from Chennai showed adequate knowledge of COVID-19 in the medical environment. Postgraduate students were more aware about the current status of usage of Ritonavir for COVID-19. This study demonstrates the urgent necessity for all health-care workers to regularly implement educational interventions and training program on infection control procedures for COVID-19.

Soft tissue re-growth after different crown lengthening techniques among Indian patients

Patients often report complaining of fractured or decayed teeth with severe morphological deformities. However, all these clinical scenarios require the same level of care and consideration to rehabilitate form, function and esthetics. Some cases have sufficient clinical crown height while others often require an interdisciplinary approach in the form of orthodontic/surgical extrusion or surgical periodontal options. A common factor delaying treatment is soft tissue regrowth after crown lengthening which delays the impression required for final prosthesis. Therefore, it is of interest to compare the prevalence of soft tissue regrowth a week after different crown lengthening techniques including laser gingivectomy, electrocautery gingivectomy, modified Widman flap and apically repositioned. The parameters assessed included 1-week postoperative soft tissue regrowth after crown lengthening, age of patients and gender. It was observed that laser and electrocautery-assisted gingivectomy had a higher rate of soft tissue regrowth as compared to surgical techniques. It was further noted that laser and electrocautery assisted gingivectomy had a higher frequency of soft tissue rebound growth compared to surgical crown lengthening using modified widman flap and apically repositioned flap, which was statistically insignificant. Patients within the age groups of 26-60 years were found to have a higher tendency of soft tissue regrowth, which was found to be clinically and statistically significant (p<0.05).

The Potential Impact of Salivary IL-1 on the Diagnosis of Periodontal Disease: A Pilot Study

The aim of this study was to identify inflammatory cytokines as salivary biomarkers for periodontal disease. The subjects were 33 Korean adults aged 23 to 71 years. Using a multiplexed bead immunoassay called Luminex, the levels of inflammatory cytokines related to periodontal disease were evaluated. Oral examination for periodontal disease and gingival bleeding was conducted. With these two independent variables, differences in inflammatory cytokines were analyzed by an independent t-test and age-adjusted ANCOVA. Among the subjects, 21 had periodontal disease and 12 were healthy subjects. The gingival bleeding status was classified into low and high levels. Among 13 inflammatory cytokines in saliva, IL-1α, IL-1β, IL-4, IL-8, CCL2/MCP-1, CCL3/MIP-1α, and TNF-α were found to be significant biomarkers within the standard curve. The quantity of IL-1β was increased in subjects with high levels of gingival bleeding. IL-1α levels were increased in subjects with periodontal disease. After adjusting for age, the significant biomarkers for gingival bleeding and periodontal disease were IL-1β and IL-1α, respectively. Using the receiver operating characteristic (ROC) curve, IL-1β was confirmed as a significant biomarker. The sensitivity and specificity of IL-1β for predicting periodontitis were 88.24% and 62.5%, respectively. Therefore, IL-1 was found to be a significant biomarker for periodontal disease, and it could be used in the diagnosis of periodontal disease using saliva.

Etanercept prevents TNF-α mediated mandibular bone loss in FcγRIIb-/- lupus model

Patients with systemic lupus erythematosus are at increased risk for alveolar bone loss due to periodontitis possibly as a result of a pathogenic immune response to oral bacteria and inflammation. The aim of the present study was to investigate whether an anti-TNF-α antagonist could prevent mandibular bone loss in the FcγRIIb^-/- mouse model of lupus. Mice lacking FcγRIIb had decreased cancellous and cortical bone volume at 6 months of age. Etanercept increased cancellous but not cortical bone volume in WT and increased both cancellous bone volume and cortical thickness in FcγRIIb-deficient mice. FcγRIIb deficiency decreased mRNA levels for osteoblast marker genes, Osx, Col1a1 and Alp without any change in osteoclast marker genes. Etanercept increased Osx, Alp, and Ocn in both WT and FcγRIIb^-/- mice. Osteoclast marker genes including TNF-α, Trap and RANKL/OPG ratio was decreased in WT. Serum markers of proinflammatory cytokines, TNF-α, IFNγ, IL-6, and IL-17A, were increased in FcγRIIb^-/- mice and etanercept antagonized these effects in FcγRIIb^-/- mice. Etanercept increased serum PTH levels in the FcγRIIb^-/- mouse model of lupus. Our results suggest that deletion of FcγRIIb induces osteopenia by increasing the level of proinflammatory cytokines. Etanercept is effective in preventing mandibular bone loss in FcγRIIb^-/- mice, suggesting that anti-TNF-α therapy may be able to ameliorate mandibular bone loss in SLE patients with periodontitis.

Effectiveness of Chitosan Nanohydrogel as a Bone Regenerative Material in Intrabony Defects in Patients With Chronic Periodontitis: A Randomized Clinical Trial

Aim:

Different procedures have been attempted to regenerate intrabony defects in periodontitis but complete regeneration is still a herculean feat. Nanoparticles could prove to be advantageous because of their small size and increased surface area. The aim was to evaluate the effectiveness of a chitosan nanohydrogel as a periodontal regenerative material in the management of intrabony defects.

Materials and Methods:

Twenty patients within the age group of 30 to 60 years with intrabony defects >3 mm and clinical attachment levels >5 mm were selected. They were divided randomly into two groups: group-1, which received only open flap debridement with bone graft and acted as control, and group-2, which received open flap debridement, bone graft mixed with a chitosan nanohydrogel, and acted as the test site. Clinical and radiographic measurements were recorded at baseline, three months, and six months. Intragroup comparison was done using a paired t-test and intergroup comparison was done using an unpaired t-test with the statistical value set at P < .05.

Results:

Chitosan hydrogel incorporated bone grafts showed improved bone regenerative potential. The mean reduction in clinical attachment level in group-2 (8.7 ± 0.6 to 1.6 ± 0.8) was significantly higher than that of group-1 (8.6 ± 0.5 to 2.4 ± 0.7). The mean reduction in probing depths in group-2 (test group) was significantly higher (8.3 ± 0.9 to 1.6 ± 0.8) when compared to group-1 (8 ± 0.8 to 2.3 ± 0.7). Significant amount of defect fill was obtained in both the groups from baseline to six-month period.

Conclusion:

Organic materials such as chitosan could have potential bone regenerative capacity.

Views on antioxidant mouthwashes as adjunct in periodontal therapy

Clinical decision is often difficult with chlorhexidine mouthwash. The use of antioxidant mouthwashes for the treatment of periodontal disease is in practise. Therefore, it is of interest to collect gleaned information on Antioxidant mouthwashes as periodontal therapy from known literature. Improvement in treatment using antioxidant mouthwashes is reported in several studies. The mouthwash with antioxidants has similar anti-gingivitis, antiplaque and antimicrobial effects as that of chlorhexidine mouthwash.

Effects of smoking on non-surgical periodontal therapy in patients with periodontitis Stage III or IV, and Grade C

BACKGROUND

To evaluate possible effects of smoking on clinical, biochemical, and microbiological outcomes of non-surgical periodontal treatment in patients with periodontitis Stage III or IV and Grade C.

METHODS

Conventional quadrant-wise non-surgical periodontal treatment was performed and whole-mouth periodontal measurements were recorded at baseline, 1, 3, and 6 months after completion of treatment. Saliva, gingival crevicular fluid, subgingival plaque, and blood samples were obtained at the same time points. Inflammatory cytokine levels, presence, and quantities of 11 different bacterial species were determined. Smoking status was validated by cotinine assay.

RESULTS

Fourteen smoker and 13 non-smoker patients completed the study protocol and revealed similar clinical findings except for the higher plaque scores in the non-smokers at 6 months (P <0.01). Significant differences were found between the study groups in biofluid cytokine levels at 1 and 3 months (P <0.01). Gram-negative bacteria were more abundant in the smokers at baseline and so were Gram-positive bacteria in the non-smokers (P <0.01). Gram-negative bacteria repopulated in the smokers faster than in the non-smokers (P <0.01).

CONCLUSIONS

The present findings suggest that smoker patients with periodontitis Stage III and IV, Grade C respond well to the non-surgical periodontal treatment during the 6-month follow-up. However, smokers exhibit faster repopulation of Gram-negative bacteria.

Modulation of salivary cytokines in response to alcohol, tobacco and caffeine consumption: a pilot study

It has been shown that long-term stimulant consumption alters the biological and microbiological status of the oral cavity. We present a pilot study describing stimulant-specific oral immunomodulation in the oral cavity. Changes in salivary cytokine levels in response to long-term alcohol, tobacco and caffeine were identified. Volunteers were recruited from amongst the patients visiting University Dental Clinic of CEU Cardenal Herrera University (Alfara del Patriarca, Spain). Participants were grouped according to their self-reported levels of consumption of either caffeine, alcohol or tobacco (control group volunteers were non-consumers of all three). Informed consent was provided and stimulated saliva samples were obtained and assayed for interleukin-1α IL-1α), Tumor Necrosis Factor α (TNF-α) and Interferon γ IFN-γ). Long-term, high-level consumers of alcohol or tobacco exhibited elevated salivary concentrations of the three inflammatory cytokines with respect to control values. Specifically, IL-1α was found to be elevated in alcohol users whilst IFN-γ concentration higher in tobacco users versus controls. Long-term caffeine consumers displayed elevated levels of IFN-γ and TNF-α, whereas IL-1α levels were reduced with respect to control volunteers. This pilot study demonstrates that salivary cytokines can be modulated in response to quantity and duration of alcohol, caffeine or tobacco consumption.

IL-6 and TNF-α salivary levels according to the periodontal status in Portuguese pregnant women

Background

Periodontitis is associated with increased concentration of inflammatory markers and saliva has been proposed as a non-invasive diagnostic fluid in oral and systemic diseases. The levels of salivary biomarkers, such as cytokines, could potentially be used to distinguish periodontal healthy individuals from subjects with periodontal disease. The purpose of this study was to characterize the salivary levels of two inflammatory biomarkers associated with periodontitis, interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α), in order to assess whether these cytokines salivary levels could potentially be used to complement periodontitis pregnant women diagnose.

Methods

Forty-four pregnant women were distributed into three groups, according to their periodontal status: healthy, mild/moderate periodontitis and severe periodontitis. Unstimulated saliva was collected and analysis of TNF-α and IL-6 salivary levels were performed with Immulite^®.

Results

Women with periodontitis exhibited significantly higher levels (p = 0.001) of salivary IL-6 and TNF-α compared with the healthy group: 25.1 (±11.2) pg/mL vs. 16.3 (±5.0) pg/mL and 29.7 (±17.2) pg/mL vs. 16.2 (±7.6) pg/mL, approximately 1.5 and 1.8 times more, respectively. Additionally, cytokines were significantly increased (p < 0.05) in severe periodontitis compared to periodontal healthy pregnant women.

Conclusions

These results revealed that IL-6 and TNF-α salivary biomarkers provide high discriminatory capacity for distinguishing periodontal disease from periodontal health in pregnant women.

Cytokine profile in gingival crevicular fluid and plasma of patients with aggressive periodontitis

OBJECTIVE

This study aimed to determine the content of cytokines in gingival crevicular fluid (GCF) as well as in plasma of Sudanese patients with aggressive periodontitis (AgP) and healthy controls (HC).

MATERIALS AND METHODS

Nineteen AgP patients and 19 HC were included. The mean probing pocket depth and clinical attachment level of the GCF sampled sites in patients were both ≥5 mm. The GCF and plasma levels of 27 cytokines were determined using 27-multiplex fluorescent bead-based immunoassays. Ratios were calculated among cytokines of the T-helper cell subsets Th1 and Th2. Descriptive statistics, the Mann-Whitney U-test and Spearman's rho rank correlation coefficient analysis were used.

RESULTS

Interferon-γ was the only cytokine found in significantly lower levels in GCF of patients compared with HC. Levels of interleukin (IL)-10, IL-13, IL-1Ra, monocyte chemoattractant protein-1 (MCP-1), regulated on activation normal T-cell expressed and secreted (RANTES), granulocyte-colony-stimulating factor (G-CSF), and granulocyte-macrophage-CSF (GM-CSF) were significantly lower in plasma of AgP compared with HC. The ratios of Th1:Th2 in GCF and Treg:Th17 in plasma were significantly lower in AgP.

CONCLUSIONS

The lower levels of cytokines detected systemically in plasma of AgP patients may have an impact on the immune response. The lower ratio of Th1:Th2 cytokines in GCF samples of AgP patients suggests a role for Th2 at the local site of disease.

The association between oral hygiene and periodontitis: a systematic review and meta-analysis

Objective: Dental plaque accumulation and inadequate personal oral hygiene (OH) are known major risk factors of periodontitis. Nevertheless, the magnitude of their effects has not yet been the subject of a meta-analysis. Material and methods: The Medline and Scopus databases were searched up to May 2016. Observational studies were eligible if they assessed associations between OH and periodontitis in adult subjects. A multivariate random-effects meta-analysis was used to pool the effects of fair/poor OH versus good OH on periodontitis across studies. The associations between oral care habits and periodontitis were also assessed. Results: A total of 50 studies were eligible; 15 were used for pooling the effect of fair OH versus good OH and poor OH versus good OH on periodontitis, with pooled odds ratios (ORs) of 2.04 [95% confidence interval (CI): 1.65–2.53] and 5.01 (95% CI: 3.40–7.39), respectively. Eleven studies examined oral care habits measured according to toothbrushing regularity and dental visit frequency; pooled ORs of 0.66 (95% CI: 0.47–0.94) and 0.68 (95% CI: 0.47–0.98) were obtained, respectively. Conclusions: Fair to poor OH increases the risk of periodontitis by two- to five-fold. This risk can be reduced by regular toothbrushing and dental visits.

Effects of Porphyromonas gingivalis LipopolysaccharideTolerized Monocytes on Inflammatory Responses in Neutrophils

Periodontitis is a chronic inflammatory disease induced by bacteria. Exposure of the host to periodontal pathogens and their virulence factors induces a state of hyporesponsiveness to subsequent stimulations, which is termed endotoxin tolerance. The role and mechanism of lipopolysaccharide (LPS)–tolerized monocytes in inflammatory responses in neutrophils are currently unclear. Here, conditioned supernatants were collected from THP-1 cells treated with or without repeated 1 μg/ml Porphyromonas gingivalis (P.gingivalis) LPS. The chemotactic response of freshly isolated neutrophils recruited by supernatants was determined by a transwell migration assay, which demonstrated a reduced migration of neutrophils stimulated with supernatants from tolerized THP-1 cells in comparison to non-tolerized THP-1 cells. In addition, there was a marked increase in reactive oxygen species (ROS) generation and a significant decrease in Caspase 3 activities in neutrophils treated with supernatants from THP-1 cells that were treated repeatedly with P.gingivalis LPS in comparison to single treatment. A cytokine antibody array was then used to assess cytokine expression patterns in THP-1 cells. In tolerized THP-1 cells, 43 cytokine (43/170) expression levels were decreased, including chemokine ligand 23 (CCL23) and IFN-γ, while 11 cytokine (11/170) expression levels were increased, such as death receptor 6 (DR6). Furthermore, there was decreased production of IFN-γ and epithelial neutrophil activating peptide-78 (ENA-78) in THP-1 cells after stimulation with repeated P. gingivalis LPS in comparison to single challenge, which was confirmed by ELISA. Therefore, P.gingivalis LPS- tolerized THP-1 cells were able to depress neutrophil chemotaxis and apoptosis, and contribute to respiratory burst, which might be related to the changes in cytokine expression patterns in THP-1 cells.